The primary goal of my scientific work is to provide empirically derived knowledge to address medical neglect of children in the child welfare system: 1) by developing a better conceptual understanding of the variables that affect the caregivers'medical neglect of children through exploring both the antecedents and consequences of this neglect (developing a preliminary explanatory model);and 2) by developing an intervention for caregivers that addresses the protective and risk factors for medical neglect and increases caregivers'ability to engage in behaviors that lead to better healthcare outcomes for their children. I will meet five training goals: 1) Increase knowledge of child neglect, specifically medical neglect;2) Increase my conceptual and empirical focus on family dynamics/parenting;3) Develop ability to utilize a research mixed method approach;4) Develop community-based interventional research skillset;and 5) Train in the responsible conduct of research. A 4-phase research agenda, in which findings from each phase inform the next research project, is proposed. The research sites are in Los Angeles County, one of the largest child welfare systems in the United States. Phase one includes a secondary quantitative analysis of data from an adolescent neglect study to explore the relationship of medical neglect to other types of maltreatment, and to identify differences in caregivers who have children who suffer from medical neglect from caregivers who have children with other types of maltreatment or without reported maltreatment. For phase two, a qualitative study using a semi-structured interview of child welfare caregivers is planned to discover the key factors that influence caregivers'help-seeking, accessing, and using/adhering to pediatric healthcare. Phase three includes a prospective medical chart review using mixed methods to identify factors that predict attendance at return appointments at a child welfare primary pediatric clinic (medical home). Finally, phase four will include a qualitative study of caregivers, pediatricians and child welfare professionals to identify factors likely to influence the feasibility and acceptability of interventions (derived from the conceptual model developed in phases 1-3) directed at caregivers to decrease medical neglect. The public's health is compromised because children in the child welfare system have significantly poorer physical health than Medicaid-eligible children not in foster care and do not receive adequate health care services while in the child welfare system. This study develops interventions for caregivers in the child welfare system, as child welfare caregivers are beginning to be recognized as gatekeepers for accessing pediatric healthcare